Fluoride for Kids

"I'm totally confused about how much fluoride my toddler needs. Should she be using a fluoride toothpaste or will she get too much fluoride?"

Even though most parents know that fluoride is critical for keeping their kids’ teeth cavity-free, there’s a lot of misunderstanding over how much of this crucial mineral their children need — and when it’s safe to start brushing with fluoride toothpaste. But one thing is certain — even the tiniest tots need fluoride because it fights cavities from the inside out. When it’s ingested, through fluoridated water or a supplement, the mineral becomes part of the tooth’s structure. And when it’s applied to those pearly whites via toothpaste, it builds enamel, which can wear down thanks to acid-producing bacteria that your munchkin’s mouth churns out after eating and drinking (especially sweet and starchy foods). Since fluoride slows down and even stops the process, it’s best that kids get this cavity-fighter from more than one source.

So now that you know what fluoride does for kids, here’s what you can do to make sure your sweetie’s smile gets the fluoride it needs to stay healthy.

Start early. As soon as that first pearly white pops up, you can use fluoride toothpaste on your little one — just make sure not to use more than a rice-grain size smear until your child is older than three. Ask the doctor how much fluoride is in your local water (or find out by calling your area’s water supplier — the phone number should be on your water bill). There needs to be 0.7 milligrams of fluoride per 1 liter of water to prevent cavities, but if your water supply doesn’t contain enough or you live in a community with unfluoridated tap water, the pediatrician may recommend a fluoride supplement for your baby. If you have a private well, get the water tested — although fluoride occurs naturally in most water systems, it may not be present in high enough quantities. If your water is fluoridated, give your breastfed baby a few ounces of tap water every day or mix it into formula if you’re bottle-feeding.

Ask about fluoride toothpaste. Check in with the pediatrician about using fluoride toothpaste from the get-go, as the American Academy of Pediatric Dentistry recommends. If you get the doc’s okay, get one that has the American Dental Association’s Seal of Acceptance (to make sure the fluoride levels are safe for kids). Don’t use more than a thin smear, and teach your tot to spit the paste out instead of swallowing it. (If she can't, switch to a fluoride-free toothpaste.) After your sweetie’s third birthday, squeeze a pea-sized amount on her brush and keep up the spit-don't-swallow lessons. (Hold off on fluoride mouthwash until your child turns six.)

Be wise about water. Many parents choose to give their kids bottled water instead of tap thinking that it’s healthier. But bottled doesn’t necessarily mean better, and when it comes to keeping teeth healthy, it may be worse since most brands don’t contain fluoride. If you prefer to stick with bottled water for your family, consider looking for one that’s fortified (check the label to be sure).

Is your water filtered? Carbon-based water filters, such as those from Brita or PUR, are fluoride friendly, leaving most of the mineral in the water. That’s not the case for reverse-osmosis filtration systems, such as the one Whirlpool makes, which do remove fluoride. If you happen to have one, let your child’s doctor or dentist know so your cutie can get the cavity protection she needs from other sources.

Don’t worry about kids getting too much fluoride. Between the water supply (or supplements) and toothpaste, most tots get the fluoride they need at a safe level. But it’s possible to get too much of a good thing if your little one has a tendency to eat toothpaste. Before age eight, overexposure to fluoride can cause a cosmetic condition called fluorosis, which usually appears as faint white streaks on permanent teeth. While severe cases can leave teeth more visibly stained, most are mild and can be noticed only during a dental exam. What’s most important to know: Fluorosis isn’t a disease like gingivitis, and it has no impact on overall oral health.